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Dr. Stan
Dr. Stan, Ophthalmologist
Category: Eye
Satisfied Customers: 2701
Experience:  Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
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Three weeks ago I had an event where my eyesight went to

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Three weeks ago I had an event where my eyesight went to double vision instantly and I became very nauseated followed by extreme sensitivity to light. It lasted for hours. I was grocery shopping at the time and had my son and husband pick me up. It took about 24 hours to get my vision back to Ok, but was still lacking. I've had ocular migraines for some years, but never last long and only impair vision, no pain. I'm concerned because I went to a clinic the next day and was tested for diabetes - not an issue. Not a stroke or heart atttack. I do have Polycythemia rubra vera and know that vision is something they check whenever I have an appointment. Also have the beginning of cataracts.
My real question with this is could a severe migraine permanently effect my vision? I feel that I have lost some quality of sight as a result of this.

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It is likely that you experienced a transient ischemic event in the eye due to your increased risk from polychythemia rubra vera (increased blood viscosity) which could cause brief cut-off or poor blood flow into the tiny blood vessels that supply the optic nerve (the nerve that allows you see). Such an event could take several hours to recover. It is possible to miss such a subtle ischemic event on initial evaluation. Even then, the persistent sense of reduced quality of vision in the eye supports a mild ischemic event in the optic nerve or center of vision. The presence of the early cataract can induce double vision, especially with eyes becoming imbalance, one out-of-focus compared to the other eye. The nausea symptoms may be related to the imbalance caused by the symptom. Still, an ocular migraine event would be considered given your history. I suggest that your eye doctor should closely evaluate you with Humphrey visual testing using 10-2 with red light target, perform potential acuity meter to determine what would your vision be if the cataracts were removed, and compare both eyes, and a careful check of the afferent pupillary defect (APD).

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